TY - JOUR T1 - Major cardiovascular events in patients with severe chronic obstructive pulmonary disease with and without asthma: a nationwide cohort study JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00200-2022 SP - 00200-2022 AU - Barbara Bonnesen AU - Pradeesh Sivapalan AU - Anna Kjær Kristensen AU - Mats Christian Højbjerg Lassen AU - Kristoffer Grundtvig Skaarup AU - Ema Rastoder AU - Rikke Sørensen AU - Josefin Eklöf AU - Tor Biering-Sørensen AU - Jens-Ulrik Stæhr Jensen Y1 - 2022/01/01 UR - http://openres.ersjournals.com/content/early/2022/06/30/23120541.00200-2022.abstract N2 - Background Chronic low-grade inflammation as in asthma may lead to a higher risk of cardiovascular events. We evaluated if patients with chronic obstructive pulmonary disease (COPD) and asthma have a higher risk of acute cardiovascular events than patients with COPD without asthma.Methods Nationwide multi-center retrospective cohort study of Danish outpatients with a specialist diagnosis of COPD with or without asthma. Patients with both COPD and asthma were propensity score matched 1: 2 to patients with COPD without asthma. The primary endpoint was severe major adverse cardiac events (MACE), defined as mortal cardiovascular events and events requiring revascularization or hospitalization.Results A total of 52 386 Danish patients with COPD were included, 34.7% had pre-existing cardiovascular disease, and 20.1% had asthma in addition to their COPD. Patients with pre-existing cardiovascular disease were then propensity score matched: 3690 patients with COPD and asthma versus 7236 patients with COPD without asthma. Similarly, for patients without pre-existing cardiovascular disease (6775 matched with 13 205).The risk of MACE was higher among patients with asthma and COPD versus COPD without asthma: Hazard ratio (HR): 1.25 (CI 1.13–1.39, p<0.0001) for patients with pre-existing cardiovascular disease and HR 1.22 (CI 1.06–1.41, p=0.005) for patients without pre-existing cardiovascular disease.Conclusion Among patients with COPD, asthma as a comorbid condition is associated with substantially increased risk of cardiovascular events. The signal was an increased risk of 20–25%. Based on our study and other smaller studies, asthma can be considered a risk factor for cardiovascular events among COPD patients.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest statement: All authors have completed the ICMJE uniform disclosure form, describing any conflicts of interest.Conflict of interest: Barbara Bonnesen has nothing to disclose.Conflict of interest: Pradeesh Sivapalan has nothing to disclose.Conflict of interest: Anna Kjær Kristensen has nothing to disclose.Conflict of interest: Mats Christian Højbjerg Lassen has nothing to disclose.Conflict of interest: Kristoffer Grundtvig Skaarup has nothing to disclose.Conflict of interest: Ema Rastoder has nothing to disclose.Conflict of interest: Rikke Sørensen has nothing to disclose.Conflict of interest: Josefin Eklöf has nothing to disclose.Conflict of interest: Tor Biering-Sørensen has nothing to disclose.Conflict of interest: Jens-Ulrik Stæhr Jensen has nothing to disclose. ER -